“When you gotta go, you gotta go” has been an
age old saying. These days, with our knowledge of medicine, we have
developed medications and treatments for “the urge.”

Not all urges need to be treated with
medication, but in some cases it helps. Behavioral training can
benefit any individual who feels they are making too many trips to
the bathroom.

DEFINING OVERACTIVE

Our bladders hold varying amounts of liquid at
different times of the day, and depending on our age and muscle
control, we may find that we may not make it in time to empty out
what we’ve taken in. If frequency of urination is the issue, the
first step is to determine if we are drinking more than our bladder
can reasonably hold.

In Florida or any other state with a hot
climate, drinking fluids is essential. As humans, we must stay
hydrated so our body’s many systems work effectively. When the body
puts out approximately the same amount of fluid being taken in, we
have a normal balance.

When a loved one’s system is compromised by
various illnesses, fluid balance takes on an additional meaning.
The elderly patient who retains fluid and must
take diuretics will naturally make more trips to the bathroom.
Diabetics may drink more water than their counterparts of the same
age group who do not have a blood sugar disorder.

Likewise, certain drinks will create a need for
a visit to the restroom sooner. Caffeinated drinks, even those with
low caffeine content, will “open up” the kidneys. Many soft drinks
contain caffeine in various amounts, and even some brands of bottled
water are caffeinated. Label reading is important, and so is
portion control when a loved one insists on having a favorite soda.

Keeping a small log of which fluids, a ballpark
amount, and number of trips to the bathroom within the one to two
hours following consumption can help give caregivers a general idea
of what is causing the perceived overactivity. It could be the
caffeine, or the amount of liquid taken in. Sometimes people will
sip at a drink for a much longer period than seems “normal”, and it
can be stressful to monitor. Instead of hurrying up your loved one,
note the time when the drink is finished, and go from there. If a
trip to the restroom is in order before the last sip, take a general
note of how much they’ve had, and compare it to the time since the
last bathroom trip.

WHEN NOT TO FOLLOW THE URGE

At any age, we can condition ourselves and our
bladders to be emptied frequently. While it’s a good idea to void
the bladder often enough to prevent bladder irritation, having a
loved one on an hourly schedule may increase urges. It can also
condition both caregiver and loved one that any twinge is sufficient
to visit the rest room.

When someone is memory impaired, just as a
caregiver has worked to train the loved one to frequent bathroom
visits by suggesting the bathroom (or going together), the reverse
is true. Waiting five or even ten minutes longer before a bathroom
trip may help with revising frequent urges.

TRACKING MEDICAL CAUSES

If functional abilities are compromised, such as
in neurological disease, there may be nerve challenges affecting
bladder control. Alzheimer’s patients may have trouble processing
the need to go to the bathroom. Anyone can “train” themselves to
create an overactive bladder, but it’s important for caregivers to
note this. In the attempt to forestall “accidents”, caregivers may
take their loved ones to the bathroom frequently.

This can contribute to the urge to urinate, and
family members may become accustomed to visiting more often than
needed.

Continence professionals and organizations like
The National Association for Continence offer resources for
individuals who want to know more about various types of
incontinence. There are articles, media available for purchase, and
free information on determining the actual problem. While the site
is not intended to give medical advice, it serves as first steps
toward identifying the problem, so medical staff can be informed.

DAYTIME OR NIGHTTIME

Waking more than twice in a night can fall under
the umbrella of “urge incontinence.”

However, it should be noted the amount of fluid
consumed before bed, as well as any during the night. Some loved
ones may complain about getting up to go, but in between bathroom
jaunts, they may be having a small glass before going back to bed.

Medications that have diuretic effects figure
into fluid intake and output as well. Cutting off liquids after a
certain time may work in some cases, but those with memory
challenges may not understand. Even a lucid individual will rasp at
being given a “last call” before bedtime.

Upbeat commercials aside, it is in the
caregiver’s and loved one’s best interests to examine all the
factors contributing to the overactive bladder. Before the doctor
writes the prescription, offer all details on consuming liquids,
current over-the-counter and prescribed medications (including home
herbal remedies and/or caffeine intake) before trying the “magic
bullet.”